Integrating Clinical Judgment Into the Entry-Level Nursing: A Confirmatory Factor Analytic Study.

Background and purpose: Clinical judgement (CJ) is a complex variable that utilizes higher level cognitive processing related to clinical reasoning, decision-making, and critical thinking. As CJ is a vital aspect of nursing, the current study evaluated the extent to which the current NCLEX item bank assesses CJ and a critical aspect of measuring new constructs using a dimensionality analysis. Methods: A Confirmatory Factor Analysis was completed to evaluate the factor structure of items written to the National Council of State Boards of Nursing Clinical Judgment Measurement Model (CJMM) that directly measures CJ with respect to extant NCLEX items. Results: Results indicated that scenarios written using the CJMM were found to have a unidimensional structure. Conclusions: The results suggested that the scenarios written with the CJMM could be scaled concurrently with the current NCLEX items.